Department of Surgery, Hospital Universitario Clínico San Carlos, C/Profesor Martín Lagos SN, 28040, Madrid, Spain.
Department of Surgery, Universidad Complutense, Madrid, Spain.
Surg Endosc. 2021 Jun;35(6):2907-2913. doi: 10.1007/s00464-020-07729-8. Epub 2020 Jun 15.
Trocar-site incisional hernia (TSIH) after laparoscopic surgery has been scarcely studied. TSIH incidence and risk factors have never been properly studied for laparoscopic colorectal surgery.
A retrospective analytic study in a tertiary hospital was performed including patients who underwent elective laparoscopic colorectal surgery between 2014 and 2016. Clinical and radiological TSIH were analyzed.
272 patients with a mean age of 70.7 years were included. 205 (75.4%) underwent surgery for a malignant disease. The most common procedure was right colectomy (108 patients, 39.7%). After a mean follow-up of 30.8 months 64 (23.5%) patients developed a TSIH. However, only 7 out of 64 (10.9%) patients with a TSIH underwent incisional hernia repair. That means that 2.6% of all the patients underwent TSIH repair. 44 (68.8%) patients had TSIH in the umbilical Hasson trocar. In the multivariate analysis, the existence of an umbilical Hasson trocar orifice was the only statistically significant risk factor for TSIH development.
Incidence of TSIH was high, although few patients underwent incisional hernia repair. Most TSIH were observed in the umbilical Hasson trocar, which was the only risk factor for TSIH development in the multivariate analysis. Efforts should be addressed to avoid TSIH in the umbilical Hasson trocar.
腹腔镜手术后的套管切口疝(TSIH)很少被研究。腹腔镜结直肠手术的 TSIH 发生率和危险因素从未得到过适当的研究。
在一家三级医院进行了回顾性分析研究,纳入 2014 年至 2016 年间接受择期腹腔镜结直肠手术的患者。分析了临床和影像学 TSIH。
共纳入 272 例平均年龄为 70.7 岁的患者。205 例(75.4%)因恶性疾病接受手术。最常见的手术是右结肠切除术(108 例,39.7%)。平均随访 30.8 个月后,64 例(23.5%)患者发生 TSIH。然而,仅有 7 例 TSIH 患者(10.9%)接受了切口疝修补术。这意味着所有患者中有 2.6%接受了 TSIH 修补术。44 例(68.8%)患者的脐 Hasson 套管存在 TSIH。在多变量分析中,脐 Hasson 套管孔的存在是 TSIH 发展的唯一统计学显著危险因素。
TSIH 的发生率较高,尽管只有少数患者接受了切口疝修补术。大多数 TSIH 发生在脐 Hasson 套管处,这是多变量分析中 TSIH 发展的唯一危险因素。应努力避免脐 Hasson 套管处的 TSIH。